I love performing lip injections (lip augmentation or injectable lip filler), so it's always nice to get nice compliments from my patients. This is a message and photo that I recently received from a Juvederm lip augmentation patient in my NYC office:
Perfection!! Your talent is unmatched. Thank you so much for everything, I will certainly be back! (Already referring everyone to you.) Xoxo
Actual patient of Dr. Devgan, before and 5 weeks after facelift. Note the improvement in her jawline, neck, and under-the-chin contour.
Actual patient of Dr. Devgan, before and 5 weeks after facelift. Note that her scar is pink and immature, though already flat and inconspicuous. It will improve over time.
Final results from a facelift or necklift operation take up to a year to fully materialize. This is because the face and neck are highly vascular, contain a great deal of blood vessels, and hold onto fluid for some time. Scar tissue also takes about a year to evolve from a raw, pink incision to a thin, pale line.
That does not mean that you need to wait a year to look beautiful, refined, and youthful, after a facelift or necklift operation, though.
1 day after surgery: bandages come off
1 week after surgery: stitches are removed
1-2 weeks after surgery: patients feel comfortable going out in public, possibly with concealer or a modified hairstyle
2 weeks after surgery: most patients have returned to work at this point
3-4 weeks after surgery: patients feel confident about all types of work and social events
1 month after surgery: bruising is likely completely gone
3 months after surgery: swelling has come down significantly
6-12 months after surgery: swelling resolves and scars slowly mature and fade
Recovery from facelift and necklift is very tolerable overall, and most patients are fine taking 1-2 weeks off of work and social engagements to recover. If you have specific questions about recovery from these plastic surgery operations, or if you would like to be a patient in my New York City practice, please call 212-452-2400 or email office@LaraDevganMD.com.
Actual patient of Dr. Devgan, before and 6 days after labiaplasty, New York City. All scars are hidden.
Many labiaplasty patients are concerned with how long it will take them to look great after surgery. The truest answer to that question is that it will take months, because some degree of swelling is present for 6 (and sometimes more) months. Bruising takes time to resolve. Incisions need to heal. Fluid needs to be reabsorbed slowly by your body.
However, that does not mean that you will not look very good, even very soon after your surgery. If you are compliant with your icing and pelvic elevation, having a beautiful result is possible even a few days after surgery, as pictured above. This patient of mine underwent labiaplasty with labia minora and clitoral hood reduction under local anesthesia only. She is pictured just 6 days after surgery, with all scars hidden, and with her swelling present but controlled.
When you are recovering from labiaplasty, it is important for you to strictly follow your surgeon's instructions for what to do at home. For my New York City patients, I recommend a high degree of icing and pelvic elevation for the first 72 hours after surgery, no exercise for at least one month, and no sex for 6 weeks.
If you are thinking about labiaplasty and would like to see me as a patient, please call 212-452-2400 or email info@LaraDevganMD.com.
This actual patient had a small contour deficiency of her left upper lip (right side of the photo), where her mouth is open (top photo). Her lips were corrected by Dr. Devgan with near perfect symmetry (bottom photo).
In my New York City plastic surgery practice, patients are very discerning and attuned to the small details of their faces. For lip augmentation with Juvederm or Restylane, precise technique and an individualized approach to each patient allow me to achieve excellent, reproducible results.
However, sometimes lip augmentation is not perfect, even in the best hands. Swelling and bruising can take two weeks or more to come down. Lumps and bumps are possible. Asymmetry and contour deficits can occur.
When patients come to see me because they are unhappy with their existing lip filler (often performed by other doctors, nurses, PAs, or injectors), there are a few things I offer them:
If you are unhappy with lumps, bumps, or irregularities in lip filler, dissolving it with Hyaluronidase is the fastest option. Hyaluronidase (also called Vitrase or Hylenex) is an enzyme that is injected into the tissue to dissolve any hyaluronic acid based filler, including Juvederm, Restylane, and Voluma. It begins to work within 5 minutes, and with gentle massage and some patience, all of the injected filler can be completely dissolved within 1-3 days.
If there is an area with a volume deficit in the lips, or an area that is relatively small compared to the contralateral side, adding additional filler is always an option. This is a relatively quick and easy process that can smooth out any irregularities and even out an uneven area.
Hyaluronic acid based fillers like Juvederm and Restylane are not permanent, and they are absorbed by the body slowly over time. The exact duration depends on your body's metabolic rate, as well as how much you move your lips. Typically lip filler will last between 9 and 12 months. If you are not interested in pursuing an invasive approach like dissolving the filler or adding more filler, you can always wait for it to go away on its own.
For questions about lip filler or to see me as a patient, please call 212-452-2400 or email office@LaraDevganMD.com.
This actual patient of Dr. Devgan had previously experimented with lip filler that left her lips looking too large and unnatural. Dr. Devgan added volume to her upper lip to give her a more voluptuous, full appearance, while maintaining a natural look (bottom photo).
Actual patient of Dr. Devgan, before and after facelift
Actual patient of Dr. Devgan, before and after necklift
Facelift and necklift are my favorite, signature operations in my New York City plastic surgery private practice. While facelift and necklift are life-changing procedures with an extremely high degree of patient satisfaction, they are also a complex topic. This was an invited article for online physician magazine Healio.com about my systematic approach to facelift and necklift. The intended audience is medically oriented, so some portions of this article are more technical. -Dr. Devgan
As we age, our faces and necks begin to show it: tissues descend, skin becomes more lax, and the characteristic volume and shape of youth morphs into something else entirely.
In plastic surgery, we think of a young, attractive face as embodying the "inverted cone of youth," meaning that it has a heart-shaped appearance. The cheekbones are full, the jawline is sleek, and the chin comes to a soft point. There is a softness to the contours of a young face, as well. The lid-cheek junction underneath the eyes is smooth. The lips are plump. The cheeks form a gentle S-curve when viewed in three-quarters view.
Over time, typically in the fourth or fifth decade of life, the "inverted cone of youth" becomes more of a square. The face loses its upper volume and begins to develop jowls, thickness around the jawline, and laxity in the neck. The lid-cheek junction becomes more pronounced and under-eye circles look hollow and puffy, while upper eyelid skin becomes more droopy. The lips become thin and atrophic. The profile changes as the elegant angles of the neck become more obtuse.
The overarching purpose of the facelift and necklift is to restore the conformation, skin, and volume of an aging face. Surgically, this means that each one of these components must be addressed separately.
In previous eras, the facelift was an operation all about pulling tissues to a tight, taut, wrinkle-free position. In the modern era of plastic surgery, we think of the face and neck according to these composite parts.
The key to improving the conformation, or shape, of an aging face and neck is in the muscular substructure of these areas. The SMAS (superficial muscular aponeurotic system) in the face and the platysma in the neck are responsible for the strength layer that holds the tissues where they are supposed to be. It is mandatory to address the SMAS and platysma in some manner in order to achieve durable facelift and necklift results. This can be accomplished via resection and plication or plication alone in patients with atrophic or thin faces.
Once the substructure of the face and neck has been tightened, the skin is gently redraped in order to determine the extent of skin redundancy that remains. It is important not to pull or yank the skin back in an effort to smooth out all wrinkles and pleats in the skin: that is what creates the artificial, pulled, wind-blown look associated with the 1980s and 1990s. A gentle redraping of the skin will allow excision of excess tissue, without putting tension on the incision lines, and without creating a overly "done" appearance.
The most important change in facelifting techniques in the past decade is the wide acceptance of fat grafting or injectable filler as a needed adjunctive procedure. The areas of the face that experience volume loss-- the cheeks, the tear troughs, the nasolabial folds, and deep facial rhytids throughout-- require augmentation in order to restore the appearance of a youthful face. Fat grafting is a durable, reliable technique for accomplishing this goal. For those who prefer a more controlled, though temporary, approach, hyaluronic acid based fillers like Juvederm, Voluma, and Restylane are good options.
Every plastic surgical procedure must, of course, be individualized to the particular patient's anatomic situation and aesthetic concerns. When rejuvenating the face and neck, it is important to evaluate aging of the eyes, brow, and lips, as well as the quality of the skin overall, as these factors will make a measurable impact on the impression of an aging face. In my New York City based practice, it is common for patients to require a combination of procedures to address facial aging. When the patient's health status and the operation's anticipated anesthesia time allow, a combination procedure can yield extremely high patient satisfaction and beautiful, durable results.
For questions about this article, please contact Devgan via www.LaraDevganMD.com.
Click to read this article on Healio.com
